14th ICID - Poster Abstracts - International Society for Infectious ...

When citing these abstracts please use the following reference:
Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number.
Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1
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Final Abstract Number: 78.017
Session: HIV: Opportunistic Infections & Malignancies
Date: Friday, March 12, 2010
Time: 12:30-13:30
Room: Poster & Exhibition Area/Ground Level
Type: Poster Presentation
Severe febrile neutropenia (SFN) in HIV / AIDS
D. Villalon 1 , N. E. Frassone 2 , L. Marianelli 2
1 Hospital Rawson, Cordoba, Argentina, 2 Hospital Rawson, Córdoba, Argentina
Background: Neutropenia is one of the most common hematologic manifestations in HIVinfected
individuals, present in 5-10% in early stages and more than 50% in advanced stages of
the disease. Most of the data reported by SFN emerge from the analysis of cancer patients, did
not know of specific data on HIV.
Objective: To determine the clinic-epidemiological and etiological SFN episodes in HIV / AIDS.
Methods: Prospective analytic study developed from June 2007 until October 2009, at the
Hospital Rawson.
Inclusion criteria: confirmed HIV infection, more severe neutropenia (500 total neutrophils
less), plus fever (T>38 ºC).
Results: We recruited 18 patients with 22 episodes of SFN, the average age was 38.4%. 86.3%
male. A single patient presented other comorbidities associated: chronic HCV infection. Probable
causes of SFN (n: 22): Chemotherapy for NHL 5 (22.7%), disseminated mycosis 5 (22.7%). In
54.5% found only associated with drug toxicity as a likely cause, although it was present in all
cases. In 59.1% of episodes the SFN was the cause of hospitalization. The 68.2% had
pancytopenia. Probable origin of infection: respiratory 45.4%, 36.3% gastrointestinal, skin and
soft tissue 27.3%, pharyngeal and odontogenic 18.1%, urinary tract 18.1%, retinitis 9%, and
unfocused clinical 9%.The CD4 count was less than 200 in 19 episodes (86.3%). The average
duration of neutropenia and fever was 7.6 and 9 days respectively. Of all episodes, 7 (31.8%) had
microbiological isolation. Bacterial 5 (71.4%): GNB 4 and Gram-positive cocci 1. Fungi were
isolated in 2 episodes (28.5%): 1 Cryptococcus and Histoplasma 1. Microbiological performance
of the methods of diagnosis: 17.8% blood cultures, urine cultures 8.7%, bone marrow puncture
22.2%, CSF culture 20% lysis-centrifugation blood cultures by 6.6%. More empirical treatments
used: piperacillin / tazobactam 31.8%, piperacillin and amikacin, 27.2%. Mortality was 18.2%.
Bacteremia was associated with a 50% mortality.
Conclusion: Predominance in young males.
High frequency of severe neutropenia related only to drug toxicity.
Low yields of blood and urine.
GNB were isolated more frequently.
Low mortality